Provider Demographics
NPI:1831908730
Name:SHCHEGLYAK, MIKHAIL
Entity type:Individual
Prefix:
First Name:MIKHAIL
Middle Name:
Last Name:SHCHEGLYAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5253 ALDERCREST CT S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-2158
Mailing Address - Country:US
Mailing Address - Phone:503-400-1802
Mailing Address - Fax:
Practice Address - Street 1:5253 ALDERCREST CT S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-2158
Practice Address - Country:US
Practice Address - Phone:503-400-1802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances